Wiki BMA for injection

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debatortho

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I have several different physicians in different states that I bill surgical claims for that use bone marrow aspirate during surgery (mostly podiatry). Recently I've had denials for use of 38220 indicating 'payment is denied when performed/billed by this type of provider'. I then realized - per several coding articles, that I should have transitioned to and billed 20999 rather than 38220 (like 3 years ago!). However, that code, 20999, is now also denying for the same reason. Is anyone else having this issue? At this point, I do not know how to get paid for this - particularly with Medicare. I am wondering if I send a reconsideration with the OP note (since it is an unlisted code) it will be paid. Any advice is appreciated!
 
Unlisted procedures (20999) will deny on first submission. You need to submit a reconsideration with records to show what you are billing 20999 for.

I've never coded podiatry. Can you explain how your physicians are using bone marrow aspirate during surgery?
 
Yes, for arthrodesis or osteochondral injury. They typically mix the BMA with bone graft, either autograft or allograft (crushed cancellous bone chips) and place within the joint. Sometimes they will fenestrate the joint.
 
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